Opportunity to discuss ethical issues during clinical learning experience

Palese, Alvisa; Gonella, Silvia; Destrebecq, Anne; Mansutti, Irene; Terzoni, Stefano; Morsanutto, Michela; Altini, Pietro; Bevilacqua, Alessia; Brugnolli, Anna; Canzan, Federica; Ponte, Adriana Dal; Biasio, Laura De; Fascì, Adriana; Grosso, Silvia; Mantovan, Franco; Marognolli, Oliva; Nicotera, Raffaela; Randon, Giulia; Tollini, Morena; Saiani, Luisa; Grassetti, Luca; Dimonte, Valerio

doi:10.1177/0969733018774617

Cited by 12 publications

(13 citation statements)

References 25 publications

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“…A few factors emerged at the individual level: Male students were less likely to access CPGs compared to their female peers. Similar to previous findings within the same network of nursing programs concerning the opportunity to discuss ethical issues during the clinical training (Palese et al., ), male students seem to be more attracted to acquiring technical skills rather than other aspects of nursing care. Also, students attending the 3rd year were more likely to access CPGs as compared to 1st year students, confirming that attitude toward EBP increases with the progression of academic education (Brown et al., ).…”

Section: Discussionsupporting

confidence: 85%

Multilevel National Analysis of Nursing Students’ Perceived Opportunity to Access Evidence‐Based Tools During Their Clinical Learning Experience

Palese

Gonella

Grassetti

et al. 2018

Worldviews Ev Based Nurs

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Background: Easy-to-access tools have been demonstrated to improve evidence-based practice (EBP) competences among nursing students. However, students' perception of access to EBP tools (e.g., clinical practice guidelines [CPGs], protocols) is unknown.Aims: To explore: (1) nursing students' opportunity to access EBP tools during their education, and (2) associated factors.Methods: A national cross-sectional study including all Italian nursing programs. Nursing students were deemed eligible according to the following inclusion criteria: Those who (1) were attending or just ended their practical rotation lasting at least 2 weeks at the time of the survey, and (2) expressed through written informed consent their willingness to take part in the study.Participants were asked about their perceived opportunity to access EBP tools during their most recent clinical learning experience (from 0 -not at all to 3 -always). A set of explanatory variables was collected at the individual, nursing program, and regional levels by using a questionnaire.Results: Nine thousand six hundred and seven (91.6%) out of 10,480 nursing students took part in the study. Overall, 4,376 (45.6%) students perceived not at all or only a small opportunity to access EBP tools during their most recent clinical rotation. In the multilevel analysis, factors promoting access were mainly set at the clinical learning environment level (high safety and nursing care quality, high self-directed learning opportunities, high quality of the learning environment, and being supervised by a clinical nurse). In contrast, male gender and lower academic class were associated with a lower perception of accessibility to EBP tools. A consistent variability in the perceived opportunity to access EBP tools emerged across regions.Linking Evidence to Action: Evidence-based decision-making is increasingly expected from nurses. Therefore, nursing faculties should safeguard and continuously improve students' competence regarding EBP, by implementing strategies mainly at the nursing program and regional levels.

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Section: Discussionsupporting

confidence: 85%

Multilevel National Analysis of Nursing Students’ Perceived Opportunity to Access Evidence‐Based Tools During Their Clinical Learning Experience

Palese

Gonella

Grassetti

et al. 2018

Worldviews Ev Based Nurs

Self Cite

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“…At the individual level, only male gender emerged as negatively associated with IPE experiences suggesting that male students should be more supported in developing interdisciplinary skills compared with female students; however, the reasons behind these findings38 should be further explored.…”

Section: Discussionmentioning

confidence: 93%

Nursing students’ interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study

et al. 2019

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ObjectiveTo explore nursing students’ interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences.DesignNational cross-sectional study on data collected in 2016.Setting95 Bachelor of Nursing Sciences programmes; 27 Italian Universities.ParticipantsStudents who (a) were attending or just completed their clinical rotations lasting at least 2 weeks in the same unit, and (b) willing to participate in the study.Primary and secondary outcomesFirst to measure the occurrence of IPE experiences in the most recent clinical rotation; the secondary outcome was to discover factors associated with IPE occurrence.MeasuresThe primary outcome was measured using questions based on a 4-point Likert scale (from 0=‘never’ to 3=‘always’). Explanatory variables were collected at both individual and regional levels with items included in the same questionnaire.Results9607 out of 10 480 students took part in the study. Overall, 666 (6.9%) perceived not having had any IPE experience, while 3248 (33.8%), 3653 (38%) and 2040 (21.3%) reported having experienced IPE opportunities ‘only a little’, to ‘some extent’ or ‘always’, respectively. From the multilevel analysis performed using the generalised linear mixed model, factors promoting the occurrence of IPE experiences were mainly set at (a) the clinical learning environment level (high: learning environment quality, self-directed learning encouragement, learning opportunities, quality of safety and nursing care and quality of tutorial strategies); and (b) the regional level, where significant differences emerged across regions. In contrast, male gender was negatively associated with the perception of having had IPE experiences.ConclusionsA large number of nursing students experienced either ‘never’ or ‘only a little’ IPE opportunities, thus suggesting that nursing education tends to remain within the nursing profession. Limiting students’ interprofessional exposure during education can prevent future collaborative approaches that have been shown to be essential in providing best patient care. In order to increase IPE exposure, it is necessary to develop strategies designed both at the singular unit and regional levels.

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“…21 In a study in Italy, one in eight baccalaureate nursing students never perceived the opportunity to discuss their ethical issues with the staff during their clinical learning experiences. 33 Support of managers, qualities of the instructor, and the instructor’s relationship are essential factors in the learning process of nursing students in clinical environments. 1,34 Inadequate support may lead to anxiety and stress in nursing students.…”

Section: Discussionmentioning

confidence: 99%

Nursing students’ ethical challenges in the clinical settings: A mixed-methods study

2018

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Background: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process. Objectives: This study aimed to explore and to evaluate the nursing students’ ethical challenges in the clinical settings in Iran. Research design: This was a mixed-methods study with an exploratory sequential design. Participants and research context: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively. Ethical considerations: The ethical committee of Kerman University of Medical Sciences, Iran, approved the protocol of the study. Findings: Three main categories were extracted from qualitative data including Low attention of nurses to the patients’ preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the “Low attention of nurses to the patients’ preferences” subscale. Discussion: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students’ ethical challenges. Conclusion: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students’ ethical challenges and their impact on nursing students’ clinical experiences.

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Opportunity to discuss ethical issues during clinical learning experience

Cited by 12 publications

References 25 publications

Multilevel National Analysis of Nursing Students’ Perceived Opportunity to Access Evidence‐Based Tools During Their Clinical Learning Experience

Multilevel National Analysis of Nursing Students’ Perceived Opportunity to Access Evidence‐Based Tools During Their Clinical Learning Experience

Nursing students’ interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study

Nursing students’ ethical challenges in the clinical settings: A mixed-methods study

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